SWOT analysis leads to turnaround

A SWOT analysis can be a powerful tool for turning a run-down occupational health facility into a growth opportunity. Christine M. Kalina, MBA, MS, RN, FAAOHN, COHN-S/CM, a Chicago-based occupational health and safety consultant, recalls the experience of one such facility that was located within a steel mill.

"The building was 105 years old, and you could immediately see the facility was neglected. It was dirty, unkempt, the magazines were old, the couches torn, and the walls needed painting. It was located next to the furnace — a clear indication it was not valued," she remembers. "They had hired an occupational health nurse to help them reinvent the facility, and her first recommendation was to get it out of the basement."

But the problems went deeper than that. The facility staff included one physician and two occupational health nurses, none of whom was board certified. After completing competitive analysis, this was identified as a clear weakness, especially as the clinic down the street had marketed and advertised its "board-certified occupational health professional staff."

The nurses job-shared, the doctor worked part time, and there was no real staff cohesion, which had led to the nurse being brought in to manage the facility. There were no professional journals available, and staff had not been encouraged to go back and get additional credentials.

The nurse started tracking volume, and found that record keeping was poor. "There was no indication of what the actual work done was — which was another weakness," says Kalina. "You could not do an accurate break-even analysis. In addition, there was no computerized system for maintaining records."

The physician-staffed urgent care center, or "Doc in the box," was a real threat; it was operated more efficiently. "The people in the steel mill facility did not know what their budget was — which, unfortunately, is not unusual in occupational health — so they didn’t know how to price out their services to give management competitive pricing vis-a-vis the Doc in the box,’" says Kalina. "Budgets are supposed to drive operating decisions, but they couldn’t do that."

The facility did have some strengths. It had the trust of management and employees, which was significant. And it had a location no one else could match, so it had the "home-court advantage."

"There was an opportunity for a turnaround; they just needed a strategy," says Kalina. The first issue addressed was the disjointed staff; it was realigned so that it now had two full-time employees. "They looked at the current pricing, and that of different freestanding clinics around them, and then asked management for a budget. They investigated the cost of an IT system and made the purchase part of the budget," says Kalina. A year later, the facility became a competitive occupational health service in the local market.